How a 30,000 hair transplant can still leave you going bald
21:23 GMT, 26 March 2012
Former England rugby scrum-half Kyran Bracken is not especially vain, nor is he the type to lie awake worrying at night.
Yet the 2007 winner of TV reality show Dancing On Ice admits there is one issue which has preyed on his mind— his hair loss.
Kyran, now 40, started losing his hair in his 20s.
Kryan Bracken before (left) and after his hair treatment (right). 'My hair loss did knock my self-confidence. When I went out I would feel paranoid about it,' he said
‘My dad had bald patches on the top of his head when I was about five and within a few years he was practically bald, with just a bit of hair around the sides,’ says Kyran, who is married to Victoria and has three children, Charlie, eight, Jack, six, and Lochlan, two.
‘When I started to lose my hair I thought: “Oh no, I am going to go the same way”.’
The prospect upset him so much he decided to have a hair transplant — where hair follicles were removed from the back of his head and implanted on the top.
Hair transplants have seen a surge in popularity, with high-profile names such as Wayne Rooney, James Nesbitt, Louis Walsh and, as was reported last week, singer Jason Donovan all revealing they have had the procedure.
But as Kyran was to discover, the treatment may not be the miracle cure for male baldness after all.
As well as side-effects such as scarring (where the hair was taken from), the transplanted hair can go into shock and fall out — or even cause the remaining hair to do the same.
British men are more troubled by their hair loss than any other men in Europe, according to a 2004 poll.
Around three-quarters of the 1,500 men questioned said it reduced their self-esteem and two-thirds said it made them feel insecure.
Male pattern baldness affects around seven million British men. For some the problem starts as young as 18 to 22
‘I have seen men who have felt suicidal because their hair loss affects them so badly,’ says Phillip Hodson, a fellow of the British Association for Counselling and Psychotherapy.
‘For men, losing their hair is terribly symbolic to their maleness, and is a sign of getting old — decay in effect.’
Male pattern baldness affects around seven million British men and for some the problem starts as young as 18 to 22, so by the time they’re 45, they’ve lost most of it. (However, if a man starts losing hair in his 40s, the full extent isn’t apparent until his 50s or 60s).
Normally, each hair root goes through a cycle — the ‘growing phase’ — which lasts a few years as the individual hair continues to lengthen, and a resting phase lasting a few months when the hair falls out: the hair root then produces a new hair.
But in men with male pattern baldness, the roots on the front and top of their head start to enter a longer resting cycle and shorter growing period, until eventually the growing phase stops altogether.
This is triggered partly by increased sensitivity to the male hormone dihydrotestosterone (or DHT), which is thought to cause the follicles to shrink, and partly by a genetic susceptibility.
The sensitivity kicks in from puberty when the hormone begins to be produced. Why the hairs at the back and sides of the head are less affected is a mystery.
Kyran started to notice his hair was thinning while watching himself playing rugby on TV.
‘I was slightly receding at the front and had these small bald circular patches on top.’
He was ribbed by his team-mates.
‘They all had a good laugh about it and gave me nicknames — cat flap was a favourite. It’s all part of the game — it’s not especially malicious.
‘But hair loss did knock my self-confidence. When I went out I would feel paranoid about it. My wife kept telling me not to worry, but I wasn’t happy about it.
‘Then I decided to retire from rugby and restart my career — as a touring judge with Dancing On Ice and as an after-dinner speaker — and it seemed the right time to do something about my hair, too.’
There are two drug treatments for thinning hair. Finasteride blocks the action of DHT, stemming further hair loss and helping growth of new hair in some men (it’s available only on private prescription and costs about 60 a month).
However, in 1 per cent of cases it may cause side-effects such as sexual dysfunction.
Another drug, minoxidil (otherwise known as Regaine), is available over the counter as a foam or lotion and works by increasing blood flow to the hair follicle. Again it helps regrowth in some.
Both drugs work only as long as they are taken. The other options are limited.
There is a technique that involves using a low-level laser light on the head which is said to stop hair loss by encouraging blood flow to the scalp.
However, the scientific evidence to support this is limited, says Dr Bessam Farjo, a hair restoration surgeon with clinics in Manchester and London.
Hair transplant is another option, though at a cost of up to 30,000 it is not cheap. Normally a hair transplant involves cutting out a strip of skin measuring about 22cm by 1cm from the back of the head.
‘We divide this graft into natural groupings of one to four hair roots and transplant these into tiny holes made across the balding patches at the top or front of the head,’ says Dr Farjo.
This leaves a thin scar at the back of the head, so for those whose existing hair would not cover this up there is another option called follicular unit extraction, where hair follicles are individually extracted rather than taken out in one big strip.
‘If a man is in his mid-40s and is a bit bald on top, then it would take a couple of operations to resemble his former density of hair,’ Dr Farjo says.
‘But you can have a hair transplant at any age — my oldest patient was 81 — and it is easier to do when the hair loss is advanced.’
However, things can go wrong — for example, the transplanted roots will not always grow hair.
‘An acceptable failure rate is for around 5-15 per cent of the roots to not grow hair,’ says Dr Farjo.
But as well as the transplanted hair going into shock and falling out, so too can the existing hair.
‘Sometimes I will tell men that I will not do a transplant for them as they have too much hair and this could fall out,’ adds Dr Farjo.
Even with a transplant, men can continue to lose what remains of their hair on top and at the front — so over time they may require more than one or two operations. But there is a limit to the amount of transplants you can do.
‘We have 100,000 hairs on our head and we can move around 6,000 to 7,000 hairs in one operation on average and up to 25,000 hairs in total over a lifetime,’ says Dr Farjo.
There can be other side-effects as well. Some men may experience swelling or numbness of the scalp.
It is perhaps not surprising some men aren’t that pleased with their transplant.
‘I would say the majority of men are happy but I have come across those who definitely are not,’ says Marilyn Sherlock, chairman of the Institute Of Trichologists.
‘The technique has really improved over the past 20 years, but I have been to court with people who have been left with scarring on their scalp. I think the key is to always go for a surgeon by recommendation.’
Kyran admits his four-hour procedure in 2006 was uncomfortable.
‘I had a local anaesthetic but even so it was still painful and continued to feel sore for four or five days afterwards.’
He went on holiday and all the implanted hair on the top of his head fell out within a few weeks.
This is normal — the transplant process pushes the transplanted hair into the resting phase so it falls out, but two or three months later most of it starts to grow again.
Happily, within six months Kyran’s hair grew back and he had a full head of hair. ‘It looked great and I was really, really pleased with the result,’ he says.
However, a year later, while appearing on Dancing On Ice in 2007, he started to notice a few bald patches again. The old hair on his head was falling out.
‘I wasn’t exactly devastated as I knew that this would happen,’ says Kyran.
‘The make-up girl on the show used some natural hair fibres (called Viviscal hair loss concealer fibres), which you shake onto your scalp and help disguise the bald patches. It really worked well and my hair looked denser.’
Even though he still finds the idea of losing his hair upsetting, Kyran has ruled out further surgery and instead uses the hair fibres daily.
Kyran hopes that with the help of people like himself and Wayne Rooney talking about their hair loss, it will become less taboo.
‘I would advise any man starting to go bald to look round at the options. Until now many have just struggled on feeling a deep lack of confidence.
‘You don’t realise how much hair loss can affect the way you feel until it happens to you.’
For more information, visit viviscal.co.uk